1. Field of the Invention
This invention relates to arthroscopic dressing systems for covering and protecting one or more skin portals which are formed in an arthroscopic surgical procedure and other surgical or medical situations where large volumes of fluid exit the skin openings.
2. Prior Art
Dressings and dressing systems for covering an opening or portal which has been created by puncturing a patient""s skin during a surgical procedure have, of course, long been known and are in common use. Such earlier dressing systems used postoperatively to cover the knee or shoulder have, in particular, often been inadequate when the surgical procedure results in considerable fluid drainage. Similarly, dressings for other surgical procedures, such as liposuction, that also involve extensive fluid drainage, have often not been adequate and have required close monitoring to avoid leakage around the dressing. Heretofore, dressings for such procedures have had to be changed often and when such dressings use adhesive tapes to secure the bandage pads in place, such have caused blistering, rashes and pain when removed. Further, such earlier dressings have taken considerable time to maintain, with medical personnel having to regularly check the condition of the dressing.
The invention meets a need for a superabsorbent dressing suitable for holding a large volume of fluid by providing a dressing having, as an absorbent pad component, a mat formed from a highly absorbent material maintained within an elastic edge by adhesive sections to provide a watertight seal, with the selected highly absorbent material providing a wicking action that removes fluid from the wound site and suspends that fluid away from the patient""s skin.
Bandages and dressings for fixation to the body and, in particular, to bodily areas at the knee and shoulder are, of course, well known in the art. A very early example of such a dressing for fitting over a specific body area is found in a Gorse, U.S. Pat. No. 663,749, with later dressings designed for convenient application over arm and leg joints shown in Stubbs, U.S. Pat. No. 3,463,147; and Graham, U.S. Pat. No. 3,521,632. None of which earlier dressings, however, provides for sealing the dressing to the patient""s skin nor for an island component or components applied first to the skin, with such island component or components constructed of an absorbent material that is capable of efficiently wicking fluid away from the wound site into a second reservoir cover of the dressing.
Examples of a use of highly absorbent materials to absorb and retain body fluids passed from a body cavity are shown in Coates, U.S. Pat. No. 4,704,107; to Jackson, U.S. Pat. No. 4,753,648; and to Papajohn, U.S. Pat. No. 4,758,241. None of which patents, however, deals with surgical dressings. Surgical dressings having an absorbent pad that is sealed by a separate section of material whereto an adhesive is applied are shown in Scheuermann, U.S. Pat. No. 4,784,128; to Carn, et al., U.S. Pat. No. 5,425,702; and to Carn, et al., U.S. Pat. No. 5,152,282. However, none of these dressings involves separate components, like the invention, to include one or more island components that are placed over a portal formed through a patient""s skin, which island component or components are then covered by a reservoir component that is an absorbent pad placed over the island component or components. Unique to the invention, the island component or components are fitted and maintained over the portal and may or may not include an adhesive outer rim. Also, the reservoir cover, designed to fit over the installed island component or components and surrounding skin, is an absorbent pad that collects and holds fluids which have passed though the island component or components and gently compresses the surgical field to encourage fluid to egress through the portal, decreasing swelling of the extremity. The reservoir cover that is placed over the island component or components collects and holds the postoperative drainage fluid and prevents fluid escape during the postoperative period.
It is a principal object of the present invention in an arthroscopic portal dressing to provide a surgical dressing that is composed of separate dressing components to include an island component or components that are placed over an arthroscopic portal to capture and hold fluids, causing the fluids to drain away from the portal and away from the patient""s skin, and a separate reservoir cover component that is provided to cover the island component or components and surrounding skin area to collect and hold fluids passing through the island component or components, holding such collected fluids over a significant period of time.
Another object of the present invention in an arthroscopic portal dressing is to provide, as an island component, a highly absorbent pad that is secured, in sealing engagement, to the patient""s skin around the portal to absorb and wick away collected fluid passed from that portal, and a reservoir cover that also includes a highly adsorbent but larger pad that is covered with a water impervious material, with the pad to receive and contain fluid passed thereto from the island component or components and with the reservoir cover having edges that are contoured and formed to fit closely to the area of the skin contacted by the cover edges.
Another object of the present invention in an arthroscopic portal dressing is to provide, with the reservoir cover, a dressing that conforms to the contours of a body area, such as the knee or shoulder, and is arranged to fit closely and maintain the cover edges to the skin surface.
Still another object of the present invention in an arthroscopic portal dressing is to provide an arrangement for gently compressing the skin and soft tissues at the portal to encourage drainage.
Still another object of the present invention in an arthroscopic portal dressing is to provide a dressing consisting of an island component or components that are formed from an absorbent pad material and are each arranged for seating over a portal to seal around the pad edges with the material selected for the pad to wick fluids passed from the portal away from the skin surface; and a reservoir cover that also includes an absorbent pad and is maintained by a waterproof cover over the island component or components to collect and maintain fluid passed from the island component or components away from the patient""s skin for a significant period of time.
Still anther object of the present invention in an arthroscopic portal dressing is to provide a dressing that is easy and convenient to apply to a patient""s incision portal to contain a large volume of fluid passed from the portal and to discourage fluid leakage from the dressing edges over a significant period of time between dressing changes.
The arthroscopic portal dressing of the invention includes separate components that are individually arranged for convenient application over an arthroscopic portal or portals that has or have been formed into a patient""s skin, as for example during a knee or shoulder surgery, and wherefrom bodily fluids drain. The dressing includes an island component that includes a pad formed from a highly absorbent material, such as a hydrophilic foam, that is surrounded by an adhesive rim or coated border that, when pressed onto the skin area surrounding the portal, will seal thereto, with the pad to wick bodily fluids from the portal away from the skin. The dressing further includes a reservoir cover that also incorporates an absorbent pad covered by a section of a water impervious material and is contoured to fit over the skin area around the portal. For example, where the dressing is used to cover a knee portal or portals as formed in a knee arthroscopic surgical procedure, the cover may be formed as a trapezoid with the long side to be fitted around the thigh and the short side to fit around the leg. Where, when such dressing is to be applied to cover a shoulder portal or portals, the cover can be formed to have a butterfly shape having pairs of wings of different lengths. The pair of wings having the longer lengths are to extend across the collar area with the shorter length wings to join around the arm. To maintain the reservoir cover in place, so as to hold the fluid absorbent pad material onto the patient""s skin, covering over the island portal or portals, the opposite reservoir cover ends may be bound with a thin section of a waterproof material and may include an elastic material, such as an elastic thread that is sewn along the cover ends and is used to draw the cover ends closely to the skin surface, sealing against fluid passage. Further, a strap or straps are provided with the cover to wrap around the dressing, providing a tight or constricted fit of the reservoir cover over the portal or portals in the skin, encouraging a fluid flow therefrom and may be used to hold a cold, gel, or ice pack, or the like, over the joint. Alternatively, to further increase compression to the area around the portal or portals, an elastic band can be fitted around the dressing. Also, depending upon the dressing use, the reservoir cover edges can include a strip or strips of a skin friendly adhesive, or velcro type fastening strips which can be secured thereto, for coupling to one another to secure the reservoir cover over the island component or components and surrounding skin surface area, as appropriate.